Sex disparities in the treatment and outcomes of ventral and incisional hernia repair

Background Despite females accounting for nearly half of ventral and incisional hernia repairs performed each year in the United States, shockingly little attention has been paid to sex disparities in hernia treatment and outcomes. We explored sex-based differences in operative approach and outcomes...
Ausführliche Beschreibung

Background Despite females accounting for nearly half of ventral and incisional hernia repairs performed each year in the United States, shockingly little attention has been paid to sex disparities in hernia treatment and outcomes. We explored sex-based differences in operative approach and outcomes using a population-level hernia registry. Methods We performed a retrospective review of the Michigan Surgical Quality Collaborative Hernia Registry (MSQC-HR) to identify patients undergoing clean ventral or incisional hernia repair between January 1, 2020 to December 31, 2021. The primary outcomes were risk-adjusted rates of laparoscopic/robotic approach, mesh use, and composite 30-day adverse events stratified by sex. Risk adjustment between sex was performed using all patient, clinical, and hernia characteristics. Results 5269 patients underwent ventral and incisional hernia repair of whom 2295 (43.6%) patients were female. Mean age was 53.9 (14.5) years. Females had slightly larger hernias (3.5 cm vs. 3.0 cm, P < 0.001), fewer umbilical hernias (50.9% vs. 73.0%, P < 0.001), and a higher prevalence of prior hernia repair (17.9% vs. 13.4%, P < 0.001). In a multivariable logistic regression adjusting for differences between males and females, female sex was associated with lower odds of mesh use [aOR 0.62 (95% CI 0.52–0.74)] and higher odds of laparoscopic/robotic repair [aOR 1.26 (95% CI 1.10–1.44)]. In a similar multivariable model, female sex was also associated with significantly higher odds of composite 30-day adverse events [aOR 1.64 (95% CI 1.32–2.02)]. This equates to predicted probabilities of 11.7% (95% CI 10.3–13.0%) vs. 7.6% (95% CI 6.6–8.6%) for adverse events in females compared to males. Conclusions Despite being younger and having fewer comorbidities, women were more likely to experience adverse events after surgery. Moreover, women were less likely to have mesh placed. Additional work is needed to understand the factors that drive these gender disparities in ventral hernia treatment and outcomes. Ausführliche Beschreibung

Autor*in:	Howard, Ryan [verfasserIn] Ehlers, Anne Delaney, Lia Solano, Quintin Shen, Mary Englesbe, Michael Dimick, Justin Telem, Dana

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	Hernia Sex-based disparities Sex as a biologic variable Outcomes

Anmerkung:

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Übergeordnetes Werk:	Enthalten in: Surgical endoscopy and other interventional techniques - New York, NY : Springer, 1987, 37(2022), 4 vom: 03. Aug., Seite 3061-3068
Übergeordnetes Werk:	volume:37 ; year:2022 ; number:4 ; day:03 ; month:08 ; pages:3061-3068

Links:	Volltext

DOI / URN:	10.1007/s00464-022-09475-5

Katalog-ID:	SPR049979337